What is type 1 diabetes?

Insulin is a hormone that helps the body's cells use sugar (glucose) for energy. It also helps the body store extra energy in muscle, fat, and liver cells. Without insulin, this sugar can't get into your cells to do its work. It stays in your blood instead. And then your blood sugar level gets too high.

High blood sugar can harm
many parts of the body, such as the eyes, heart, blood vessels, nerves, and kidneys. It can also increase your risk for other health problems (complications).

Type 1 diabetes can occur at any age, but it usually
starts in children or young adults. That's why it used to be called juvenile
diabetes.

Type 1 diabetes is different from type 2 diabetes. In type 1 diabetes, the body stops making
insulin. In type 2, the body doesn't make enough insulin, or the body can't
use insulin the right way.

There isn't a cure for type 1 diabetes. But with treatment, people can
live long and healthy lives.

What causes type 1 diabetes?

The body makes
insulin in beta cells, which are in a part of the pancreas called the islet
(say "EYE-let") tissue. Type 1 diabetes starts because the body destroys those
beta cells. Experts don't know why this happens.

Some people have
a greater chance of getting type 1 diabetes because they have a parent,
brother, or sister who has it. But most people with the illness don't have a
family history.

Other things that increase the risk of
getting type 1 diabetes are being white and having
islet cell antibodies in the blood.

What are the symptoms of undiagnosed type 1 diabetes?

Symptoms of diabetes are:

Being very thirsty.

Urinating a
lot.

Losing weight without trying.

Being hungrier than
usual (sometimes).

Blurry eyesight.

These symptoms usually appear over a few days to weeks.
Sometimes people notice symptoms after an illness, like the flu. They may
think that the diabetes symptoms are because of the flu, so they don't seek
medical care soon enough.

If you wait too long to get
medical care, you may get
diabetic ketoacidosis, which is very dangerous. Symptoms of
this problem include:

Cause

Type 1 diabetes develops because the
body's
immune system destroys beta cells in a part of the
pancreas called the
islet tissue. These beta cells produce insulin. So people
with type 1 diabetes can't make their own insulin.

The pancreas normally adjusts
the amount of insulin it makes based on your changing blood sugar. When you have diabetes, your insulin
injections can't control your blood sugar moment to moment, the way your pancreas
would. So you may have high and low blood sugar levels from time to
time.

Causes of high blood sugar

Causes of high blood sugar include:

Not getting enough
insulin.

Eating more food than usual.

Stress and being
ill (such as with severe flu) or having an infection, especially if you aren't
eating or drinking enough.

Diabetic ketoacidosis

Sometimes a person's blood sugar level rises greatly before he or she knows something is wrong. Because insulin isn't available, the cells in
the body are unable to get the sugar (glucose) they need for energy. The body
begins to break down fat and muscle for energy.

When fat is used for energy,
ketones—or fatty acids—are produced and enter the bloodstream. This causes the
chemical imbalance
diabetic ketoacidosis. This can be a life-threatening
condition.

Low blood sugar

If you aren't able to tell when your blood sugar is too low (
hypoglycemic unawareness), it's a good idea to test your blood sugar often.

Risk factors for high and low blood sugar

Tight blood sugar control. Tight control of blood sugar helps prevent complications, such
as eye, kidney, heart, blood vessel, and nerve disease. But it does put you at
risk for frequent low blood sugar levels.

Adolescence. The rapid growth spurts and changing
hormone levels of adolescence can make it difficult to
keep blood sugar levels within your
target range . Your target range is the blood sugar goal
you set with your doctor.

Eating disorders. Teens are often concerned about
their weight and body image, and they may skip insulin injections to lose
weight.
Eating disorders can be much more common in girls and women of all ages who have type 1 diabetes.

Lipohypertrophy, which is fat and scar tissue that can be caused by repeatedly injecting insulin in the same place. The area may feel firmer than the skin around it. Injecting insulin into an area of fat and scar tissue means it may not be absorbed at the same rate each time, which could cause high or low blood sugars.

Gastroparesis. Damage to the nerves of the body can change how the stomach contracts when digesting food. Food can take longer to digest, which can make it harder to know when insulin will work after eating. This can lead to high and low blood sugars.

Thyroid or kidney problems. Too little thyroid hormone can slow metabolism, which can cause some medicines (like insulin) to stay in the body longer. This can cause low blood sugar. And when the kidneys are damaged, insulin may stay in the body longer, causing low blood sugar. The kidneys may also have problems making glucose, causing low blood sugar.

What Happens

It's not possible for injected insulin to work as well as a normal pancreas, so you will have high and low blood sugar levels from time to time.

Eyes

Feet and skin

You may have less feeling in your feet, which means that you can injure your feet and not know it.
Common infections from blisters, ingrown toenails, small cuts, or other problems can quickly become more serious when you have diabetes.

If you get serious infections or bone and joint deformities, you may need surgery (even
amputation ) to treat those problems.

Heart and blood vessels

Nerves

High blood sugar levels can damage nerves throughout your body. This damage is called diabetic neuropathy.
There are three kinds of diabetic neuropathy:

Diabetic peripheral neuropathy. This is damage to the nerves that sense pain, touch, hot, and cold. This type of nerve damage can lead to deformities such as
Charcot foot. It can also lead to other problems that may require
amputation.

Autonomic neuropathy. This is damage to nerves that control things like your heartbeat, blood pressure, sweating, digestion, urination, and sexual function.

Focal neuropathy. Most of the time, this affects just one nerve, usually in the wrist, thigh, or foot. It may also affect the nerves of your back and chest and those that control your eye muscles.

Kidneys

The kidneys have many tiny blood vessels that filter waste from your blood. High blood sugar can destroy these blood vessels. You won't have any symptoms of kidney damage until the
problem is severe. Then you may notice swelling in your
feet or legs or all over your body.

Hearing

High blood sugar can damage the small blood vessels and nerves in the ear, causing hearing loss.

Teeth

Gum disease can make it harder to keep blood sugar in a target range. And high blood sugar can cause gum disease, loss of teeth, and healing problems in the mouth.

Mental health

The stress of dealing with diabetes or the effects that diabetes has on your body can lead to depression.

Being depressed can make it hard to eat healthy foods and to find the motivation to exercise. All of these things lead to higher blood sugar.
By getting help for depression, you'll feel better and may find it easier to stay motivated.

What Increases Your Risk

Risk factors are things that increase your chances of getting sick or having a problem. Risk factors for
type 1 diabetes include:

A family history of type 1 diabetes. Having a family history of the disease increases the chance
that a person will have
islet cell antibodies. But it doesn't predict that a
person will have the disease.

Race. White people have a
greater risk for type 1 diabetes than black, Asian, or Hispanic
people.

Presence of islet cell antibodies in the blood. People who have both a family history of type 1 diabetes and
islet cell antibodies in their blood are likely to get diabetes. Family members of people with type 1 diabetes can be
tested to see if they have islet cell antibodies. People who are found to have
islet cell antibodies may be able to take part in studies about preventing
type 1 diabetes.

Tests to check your health

Check your blood pressure and start or adjust treatment, if
needed. Nerve and blood vessel damage can result from high blood pressure, leading to heart problems and strokes. For more information, see the topic
High Blood Pressure .

Check your feet for
signs of problems, especially if you have had diabetes for a few years. Nerve damage in your feet makes it hard to feel an injury or infection. Take off your socks each time you see the doctor to be sure you both remember to check your feet. At least once a year your doctor will do a complete examination of your feet.

Have a
hemoglobin A1c test. This blood test shows how steady your blood
sugar levels have been over time.

These visits are also a good time to talk with your doctor about how you're feeling. It's normal to feel frustrated or overwhelmed with all there is to do. If you're having trouble coping, your doctor can help.

Tests to screen for complications

After you have had type 1 diabetes for 3 to 5 years, your doctor may recommend these tests.

A
complete eye exam by an
ophthalmologist or
optometrist. High blood sugar levels from diabetes can damage your eyes. This test can find problems early. If you are at low risk for vision problems, your doctor may consider follow-up exams every 2 to 3 years.

A
foot exam to check for diabetic neuropathy. Your doctor may look at your feet for sores and calluses at every visit. If you have one or more foot problems, you may need to have your feet checked more than once a year. A child who has diabetes may not need a thorough examination of his or her feet each year until after puberty.

A
cholesterol and triglyceride test. This test shows your LDL cholesterol level. You and your doctor can adjust your treatment plan according to how high it is. If you are an adult and have normal results, you may be tested every 2 years. If your child's levels are normal, then he or she can be tested every 5 years.

A
urine test , to check for protein. If protein is found, you'll have more tests to help guide the best treatment. Protein in the urine can be a sign of kidney damage (
diabetic nephropathy).

A
thyroid-stimulating hormone test. This test checks for thyroid
problems, which are common among
people who have diabetes. If the test is normal, your doctor may suggest you have the test again every 1 to 2 years.

Eye exams during pregnancy

If you get
pregnant, you will need to have an
eye exam sometime during the
first 3 months. You'll also need close follow-up
during your pregnancy and for 1 year after you
have your baby. Pregnancy may increase your risk for
diabetic retinopathy. If you already have eye disease and
get pregnant, the disease can quickly get
worse.

Regular medical checkups. You will get routine screening tests and exams to watch for
signs of complications, such as eye, kidney, heart, blood vessel, and nerve
diseases.

Not smoking.

Not drinking alcohol if you are at risk for periods of low blood sugar.

Blood sugars are easier to predict and control when mealtimes,
amounts of food, and exercise are similar every day. So getting into a daily routine helps a lot.

Diabetic ketoacidosis

Some people find out that they have type 1 diabetes when they are admitted to a hospital
for
diabetic ketoacidosis. If their symptoms are severe,
they may need to be treated in an intensive care unit.

Treatment for diabetic
ketoacidosis includes fluids given through a vein (intravenous, or IV) to treat
dehydration and to balance
electrolytes, and insulin to lower the blood sugar
level and stop the body from producing ketones.

The honeymoon period

If your blood sugar levels return to the normal range soon after
diagnosis, you are in what is called the "honeymoon period."

This is a time
when the remaining insulin-producing cells in your
pancreas are working harder to supply enough insulin
for your body.

Treatment during this time may include:

Keeping in close touch with your doctor.

Testing your blood sugar level often, to see if it
is rising.

Taking very small amounts of insulin or no insulin. Even though
you may not need insulin, some doctors prefer that you take small doses of
insulin daily throughout the honeymoon period. This may decrease the stress on
the pancreas.

Prevention

Currently there is no way to prevent type 1 diabetes, but ongoing studies are exploring ways to prevent diabetes in those who are most likely to get it. People who have a parent, brother, or sister with type 1 diabetes and are willing to participate in one of these studies should talk with their doctors.

Preventing diabetes complications

People who have type 1 diabetes can help prevent or delay the development of complications by keeping their blood sugar in a target range. They also need regular medical checkups to detect early signs of complications. If complications are treated early, the damage may be stopped, slowed, or possibly reversed.

People who have other health problems along with diabetes, such as high blood pressure or high cholesterol, need to treat those conditions. Also, not smoking can reduce the risk of complications. Having other health problems can increase the risk for complications from diabetes.

Preventing disease

When you have diabetes, you need a
flu(What is a
PDF document?) vaccine every year. You also need a
hepatitis B (Hep B)(What is a
PDF document?) vaccine.

You may need or want additional immunizations if certain situations raise your chance for exposure to disease.

Home Treatment

Type 1 diabetes
requires daily attention to diet, exercise, and insulin. You may have times
when this job feels overwhelming, but getting into a daily routine can help. And taking good care of yourself will also help
you feel better, have a better quality of life, and prevent or delay
complications from diabetes.

Spread carbohydrate throughout the day

Carbohydrate is the one nutrient in your diet that
most affects blood sugar levels. A registered dietitian can help you learn
about what foods contain carbohydrate and how to manage it in your diet.

Exercise regularly

Try to do
moderate activity at least 2½ hours a week.1 One way to do this is to be active 30 minutes a day, at least
5 days a week.

Exercise safely . Drink plenty of water
before, during, and after you are active. This is very important when it's hot out and when you do intense
exercise. You can also try keeping track of your exercise on an
activity log(What is a
PDF document?).

Protect your feet

Daily foot care can prevent
serious problems. Foot problems caused by diabetes are the most common cause of
amputations .

Limit alcohol

In addition to exercising, it is a
good idea to limit the amount of alcohol you drink. The American Diabetes
Association recommends that women with diabetes have no more than 1 drink a
day and men with diabetes have no more than 2 drinks a day.2

Do not smoke

Having type 1 diabetes can cause a lot of
problems in your body. Smoking can make many of these problems worse,
especially heart and blood vessel disease.

Smoking raises your
cholesterol and makes it harder for your body to heal.

No matter how long you've smoked, your health will improve after you quit.

Medications

Insulin

Insulin helps keep your blood sugar level tightly
controlled and within a target range. It can be taken by an injection or through an
insulin pump.

Usually people who have type 1
diabetes take a combination of types of insulin, such as a long-acting insulin
once or twice a day and a rapid-acting insulin before each meal. The amount and
type of insulin needed varies for each person.

The amount and type of
insulin you need changes over time, depending on age, hormones (such as during
rapid growth or pregnancy), and changes in exercise routine. You may need higher doses of insulin during times of illness or emotional
stress.

Know the dose of each
type of insulin you take,
when you take the doses, how long it takes for each type of insulin to start
working (onset), when it will have its greatest effect (peak), and how long it
will work (duration).

Pancreatic islet cell surgery

Research continues on pancreatic islet cell surgery. It involves inserting a small group of donated pancreas cells (islet cells) through a vein in your liver. After surgery, these cells begin making insulin. If they can make enough, you may no longer need insulin injections.

Because the surgery is simpler than a pancreas transplant, there are usually fewer complications. But you must still take medicine to prevent rejection.

If you hear about something new to help diabetes, do some research to find out if it really works. You can also check with your doctor or a
diabetes educator. Your health plan may also provide health information on its website.

Complementary therapies

Some complementary
therapies may help relieve stress and muscle tension. They might help you feel better in general. But
they shouldn't be used instead of treatment.

Other Places To Get Help

Organizations

American Diabetes Association (ADA)

1701 North Beauregard Street

Alexandria, VA 22311

Phone:

1-800-DIABETES (1-800-342-2383)

Email:

AskADA@diabetes.org

Web Address:

www.diabetes.org

The American Diabetes Association (ADA) is a national organization
for health professionals and consumers. Almost every state has a local office.
ADA sets the standards for the care of people with diabetes. Its focus is on
research for the prevention and treatment of all types of diabetes. ADA
provides patient and professional education mainly through its publications,
which include the monthly magazine Diabetes Forecast,
books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also
provides information for parents about caring for a child with diabetes.

Juvenile Diabetes Research Foundation
International

120 Wall Street

New York, NY 10005-4001

Phone:

1-800-533-CURE (1-800-533-2873)

Fax:

(212) 785-9595

Email:

info@jdrf.org

Web Address:

http://www.jdrf.org

The Juvenile Diabetes Research Foundation International is dedicated to finding a cure for type 1 diabetes and its complications. The organization funds research on type 1 diabetes, including research on prevention and treatment. This
organization publishes a wide variety of booklets, magazines, and e-newsletters on complications and
treatments of type 1 diabetes.

National Diabetes Education Program
(NDEP)

1 Diabetes Way

Bethesda, MD 20814-9692

Phone:

1-800-438-5383 to order materials (301) 496-3583

Email:

ndep@mail.nih.gov

Web Address:

http://ndep.nih.gov

The National Diabetes Education Program (NDEP) is
sponsored by the U.S. National Institutes of Health (NIH) and the U.S. Centers
for Disease Control and Prevention (CDC). The program's goal is to improve the
treatment of people who have diabetes, to promote early diagnosis, and to
prevent the development of diabetes. Information about the program can be found
on two Web sites: one managed by NIH (http://ndep.nih.gov) and the other by CDC
(www.cdc.gov/team-ndep).

National Diabetes Information Clearinghouse
(NDIC)

1 Information Way

Bethesda, MD 20892-3560

Phone:

1-800-860-8747

Fax:

(703) 738-4929

TDD:

1-866-569-1162 toll-free

Email:

ndic@info.niddk.nih.gov

Web Address:

http://diabetes.niddk.nih.gov

This clearinghouse provides information about research
and clinical trials supported by the U.S. National Institutes of Health. This
service is provided by the National Institute of Diabetes and Digestive and
Kidney Disease (NIDDK), a part of the National Institutes of Health (NIH).

Pignone M, et al. (2010). Aspirin for primary prevention of cardiovascular events in people with diabetes: A position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation. Circulation, 121(24): 2694–2701.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the
Terms of Use .
How this information was developed to help you make better health decisions.

Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC). In Arizona, individual HMO plans are insured by Cigna HealthCare of Arizona, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Group Universal Life (GUL) insurance plans are insured by CGLIC. Life (other than GUL), accident, critical illness, and disability plans are insured or administered by Life Insurance Company of North America, except in NY, where insured plans are offered by Cigna Life Insurance Company of New York. All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico.

Selecting these links will take you away from Cigna.com. Cigna does not control the linked sites' content or links. Details